The intercristal line (also known as Jacoby’s Line or Tuffier’s Line) is a horizontal line drawn across the highest points of both the iliac crests in an anteroposterior (AP) lumbar radiograph 1,2.
The intercristal line most often intersects the body of L4 or its inferior endplate in men and the body of L5 or its superior endplate in women. In the general population, the intersection of the intercristal line may vary anywhere between the inferior end plate of the L4 to the superior endplate of the L5 1.
Its significance is twofold:
- it is a more accurate method for numbering the lumbar vertebra, and hence
- is an anatomical landmark used to avoid wrong-level spinal surgery or intervention.
History and etymology
George W Jacoby (1856-1940), an American physician proposed the line in 1895 as a landmark that intersected L4 vertebra 3,4. Five years later in 1900, French surgeon T Tuffier described the same line passing through the L4/L5 intervertebral disc. Both used the landmark for the purpose of performing a lumbar subarachnoid injection 2.
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